Background The first long-acting injectable antiretroviral, cabotegravir/rilpivirine (LA-CAB/RPV), was FDA approved in January 2021 for persons with HIV suppressed on their current regimen. Body mass index (BMI) ≥30 kg/m2 has been identified as a risk factor for virologic failure, however data is limited due to small sample sizes. The aim of this study was to evaluate the impact of BMI on the efficacy of LA-CAB/RPV in a real-world setting. Methods A retrospective, multi-center cohort study was conducted from January 22, 2021 to February 15, 2023 in individuals who received LA-CAB/RPV every 4 (Q4w) or 8 weeks (Q8w). Individuals included were virologically suppressed on their current regimen, received at least one dose of LA-CAB/RPV, and had a follow up viral load post initiation. Results A total of 374 individuals across five centers were included, with a BMI ≥30 kg/m2 in 148 (39.5%) individuals. Most individuals received a Q8w (68%) regimen and the incidence of viral load >50 copies/mL was similar between those with BMI ≥ 30 kg/m2 (12%) as compared to those with BMI < 30 kg/m2 (9%) (IRR 1.31; 95% CI 0.69 - 2.46, p=0.4). Confirmed virologic failure occurred in 0.8% of individuals overall, with two of the three cases occurring in those with BMI ≥ 30 kg/m2. Conclusion The data from this real-world cohort demonstrates no difference in virologic outcomes for individuals with BMI ≥ 30 kg/m2 as compared to those with BMI < 30 kg/m2 suggesting that higher BMI alone should not preclude use of LA-CAB/RPV in eligible individuals.

中文翻译：

---

接受长效卡博特韦/利匹韦林治疗的体重指数升高患者的真实世界病毒学结果


背景 第一种长效注射用抗逆转录病毒药物卡博特韦/利匹韦林 （LA-CAB/RPV） 于 2021 年 1 月获得 FDA 批准，用于当前方案中抑制的 HIV 感染者。体重指数 （BMI） ≥30 kg/m2 已被确定为病毒学失败的危险因素，但由于样本量小，数据有限。本研究的目的是评估 BMI 在现实世界中对 LA-CAB/RPV 疗效的影响。方法 2021 年 1 月 22 日至 2023 年 2 月 15 日对每 4 次 （Q4w） 或 8 周 （Q8w） 接受 LA-CAB/RPV 的个体进行了一项回顾性、多中心队列研究。纳入的个体在目前的方案中受到病毒学抑制，接受了至少一剂 LA-CAB/RPV，并在开始后进行了随访病毒载量。结果 共纳入 5 个中心的 374 例个体，148 例 （39.5%） 个体的 BMI ≥30 kg/m2。大多数个体接受 Q8w （68%） 方案，BMI ≥ 30 kg/m2 （12%） 的患者与 BMI < 30 kg/m2 （9%） 的患者之间病毒载量 >50 拷贝/mL 的发生率相似 （IRR 1.31;95% CI 0.69 - 2.46，p=0.4）。确诊病毒学失败发生在 0.8% 的个体中，其中 3 例中有 2 例发生在 BMI ≥ 30 kg/m2 的人群中。结论来自该真实世界队列的数据表明，与 BMI < 30 kg/m2 相比，BMI ≥ 30 kg/m2 的个体的病毒学结果没有差异，这表明仅较高的 BMI 不应排除在符合条件的个体中使用 LA-CAB/RPV。